The head of the Irish Dental Association (IDA) has said a dental treatment scheme from the State needs to be changed, as it is no longer fit for purpose.
The scheme, which has been in place since 1994, means standard medical card holders are entitled to limited dental care.
This would include an annual exam, two fillings, extractions and some other services - the dentist is then paid a fee set by the State.
But the IDA has warned the scheme, which around 1.5 million people use, is on the brink of collapse.
Fintan Hourihan, chief executive of the Irish Dental Association, told Pat Kenny the system is flawed and dentists are leaving.
"In a normal year, one in three patients would have availed of the scheme and seen their dentist.
"But last year, not surprisingly, it was down to barely one in five.
"So fewer patients are attending the dentist, but it also reflects the fact that there has been a large exodus of dentists from the scheme - so it's harder to find a dentist for patients".
People are entitled to see any dentist who is part of the scheme, but Mr Hourihan said fewer dentists are staying.
'The final straw'
He said a downfall is around the fact that once people reach their limit of fillings, extractions become an option.
"This scheme started as an entirely preventative scheme, so obviously a dentists inclination would be to look at fillings or route canal treatment: an extraction is very much the last resort".
But he admitted it "is the reality" that someone who may have reached their limit of free fillings can opt for an extraction instead.
"That is unfortunately the reality... it's something dentists are very comfortable about, but patients equally or more importantly are unhappy about.
"It cuts across the essential ethos of the scheme, which was essentially a preventative care scheme.
"Through pretty blunt cuts made in 2009, it has changed entirely and is no longer a preventative scheme.
"It's an emergency pain relief scheme, and the consequences are that rather than preventing problems or treating problems - short of extraction - it's changed fundamentally.
"It's no longer a scheme that's fit for purpose, to be quite honest".
And he said a lot of dentists were disillusioned over a lack of PPE - with some 300 leaving since the start of 2020.
"A large number of the dentists said that the additional operating costs that they incurred during COVID, because they did keep their practices open, and particularly the failure by the Department of Health to honour a promise to supply them with PPE within seven days last June was the final straw.
"They said 'this has been a scheme where it's been imperfect, but we were happy to continue with it in the hope and expectation that the department would finally sit down and come up with a better scheme'.
"But when they saw there was no sign of that... they decided that they couldn't continue with the scheme".
